Organization
SURGICAL SPECIALISTS OF CENTENNIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZAKI IBRAHIM M.D. (OWNER/PHYSICIAN)
(720) 974-2506
Entity
Organization
Contact information
Practice address
5380 AUTUMN DR, GREENWOOD VILLAGE, CO 80111-3424
(720) 974-2506
Mailing address
PO BOX 4446, PARKER, CO 80134-1451
(720) 974-2506
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-0001715
CO
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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